Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Behavior therapy effective in reducing tics in children with Tourette syndrome

19.05.2010
Improvement similar to that found in recent anti-tic medication studies but without the side effects

Tourette syndrome, a neurological disorder characterized by tics like grimacing, blinking and vocalizations, is normally treated in children and teens with one of several antipsychotic medications. But such drugs usually don't eliminate all the tics, and worse, they can often have side effects, acting as sedatives, causing weight gain and impairing cognitive function.

Now, a multisite study led by a UCLA researcher has developed an effective, non-medication treatment for children and adolescents with Tourette's and related tic disorders that has shown improvement similar to that found in recent anti-tic medication studies.

Lead study author John Piacentini, a UCLA professor of psychiatry and his colleagues at seven sites around the nation found that a specialized form of behavior therapy called comprehensive behavioral intervention for tics, or CBIT, significantly reduced chronic tics and tic-related problems in children and adolescents.

Almost 53 percent of children receiving CBIT were rated as significantly improved, compared with 19 percent of those receiving a comparison treatment, and the degree of improvement with CBIT was similar to that found in recent anti-tic medication studies.

The study appears in the May 19 issue of the Journal of the American Medical Association (JAMA).

Tourette syndrome, which affects approximately six out of every 1,000 children and adolescents, is a chronic neurological disorder characterized by motor and vocal tics, including eye blinking, facial grimacing, head jerking, throat clearing, sniffing and grunting. Although the repetition of curse words is often portrayed as the defining feature of the syndrome, cursing is an uncommon symptom and is not required for diagnosis of the disorder.

"Besides its physical manifestations, Tourette syndrome can cause a number of other problems," Piacentini said. "It is often associated with other psychiatric problems, difficulties in school, work and social functioning, and, in severe cases, can be disabling.

"Historically, Tourette syndrome has been treated with antipsychotic medications, which reduce tics but are associated with side effects that often limit their usefulness in children. So the development of an effective non-medication treatment for children with this disorder is a major therapeutic advance," he said.

CBIT is built on the observation that tics are preceded by unwanted feelings or sensations which in turn are temporarily relieved by the tics. In this treatment, children learned to recognize when a tic was about to occur and to engage in a voluntary action incompatible with the tic until the unwanted sensation passed.

In addition, parents were taught how to promote these management strategies in their children and to minimize stressful situations in their children's environments associated with tic worsening.

In the multisite study, 126 children between the ages of 9 and 17 with moderate to severe Tourette syndrome or Chronic Tic Disorder were randomly assigned to CBIT or to a supportive counseling and education program about Tourette syndrome. Approximately one-third of the children entered the study on a stable dose of anti-tic medication.

The study showed that CBIT resulted in a significantly greater reduction in tic severity and tic-related problems than the supportive counseling. Almost 53 percent of children receiving CBIT were rated as significantly improved, compared with 19 percent of those receiving the comparison treatment.

The degree of improvement with CBIT was similar to that found in recent anti-tic medication studies. Benefits were observed in both children who were on a tic medication and children not on medication. Adverse treatment effects, including tic worsening, were rare in both CBIT and supportive counseling. Treatment gains for CBIT were maintained over time, with 87 percent of available responders showing continued benefits six months after treatment had ended.

"The fact that CBIT works about as well as the standard medications for tics but without the negative side effects greatly expands the available treatment options for chronic tic disorders," said Susanna Chang, a UCLA assistant professor of psychiatry and a study author. "Importantly, CBIT also emphasizes the development of skills that foster autonomy and empowerment, allowing for patients and their families to take a more active role in treatment than previously indicated."

Piacentini noted that additional studies are underway using neuroimaging and other neuroscientific techniques to examine the brain mechanisms underlying how CBIT might work. In addition, investigators are currently working with the Tourette Syndrome Association and the U.S. Centers for Disease Control and Prevention to teach CBIT to clinicians who treat children with tic disorders and to develop new versions of CBIT for use with younger children and by nurses and other health care professionals.

Other authors on the study included Douglas Woods, of the University of Wisconsin–Milwaukee; Lawrence Scahill and James Dziura, of Yale University; Sabine Wilhelm and Thilo Deckersbach, of Massachusetts General Hospital/Harvard Medical School; Alan Peterson, of the University of Texas Health Science Center; Dr. John Walkup and Golda Ginsburg, of the Johns Hopkins Medical Institutions and Weil–Cornell Medical School; and Sue Levi-Pearl, of the Tourette Syndrome Association.

The study was funded by the National Institutes of Health. The authors report no conflict of interest.

The UCLA Department of Psychiatry and Biobehavioral Sciences is the home within the David Geffen School of Medicine at UCLA for faculty who are experts in the origins and treatment of disorders of complex human behavior. The department is part of the Semel Institute for Neuroscience and Human Behavior at UCLA, a world-leading interdisciplinary research and education institute devoted to the understanding of complex human behavior and the causes and consequences of neuropsychiatric disorders.

For more news, visit the UCLA Newsroom and follow us on Twitter.

Mark Wheeler | EurekAlert!
Further information:
http://www.ucla.edu

More articles from Studies and Analyses:

nachricht Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University

nachricht New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

Im Focus: Hybrid optics bring color imaging using ultrathin metalenses into focus

For photographers and scientists, lenses are lifesavers. They reflect and refract light, making possible the imaging systems that drive discovery through the microscope and preserve history through cameras.

But today's glass-based lenses are bulky and resist miniaturization. Next-generation technologies, such as ultrathin cameras or tiny microscopes, require...

Im Focus: Stem cell divisions in the adult brain seen for the first time

Scientists from the University of Zurich have succeeded for the first time in tracking individual stem cells and their neuronal progeny over months within the intact adult brain. This study sheds light on how new neurons are produced throughout life.

The generation of new nerve cells was once thought to taper off at the end of embryonic development. However, recent research has shown that the adult brain...

Im Focus: Interference as a new method for cooling quantum devices

Theoretical physicists propose to use negative interference to control heat flow in quantum devices. Study published in Physical Review Letters

Quantum computer parts are sensitive and need to be cooled to very low temperatures. Their tiny size makes them particularly susceptible to a temperature...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Japanese researchers develop ultrathin, highly elastic skin display

19.02.2018 | Information Technology

Dispersal of Fish Eggs by Water Birds – Just a Myth?

19.02.2018 | Ecology, The Environment and Conservation

Studying mitosis' structure to understand the inside of cancer cells

19.02.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>